Provider Demographics
NPI:1780404913
Name:TROJCAK, KIRA A (PA)
Entity type:Individual
Prefix:
First Name:KIRA
Middle Name:A
Last Name:TROJCAK
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 BOX LN APT 3115
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95818-1189
Mailing Address - Country:US
Mailing Address - Phone:253-569-6864
Mailing Address - Fax:
Practice Address - Street 1:241 BOX LN APT 3115
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95818-1189
Practice Address - Country:US
Practice Address - Phone:253-569-6864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant